Classic Labs/Findings Flashcards
1
Q
Anticentromere antibodies
A
Scleroderma (CREST)
2
Q
Antidesmoglein (epithelial) antibodies
A
Pemphigus vulgaris (blistering)
3
Q
Anti–glomerular basement membrane antibodies
A
Goodpasture syndrome (glomerulonephritis and hemoptysis)
4
Q
Antihistone antibodies
A
Drug-induced SLE (hydralazine, INH, phenytoin, procainamide)
5
Q
Anti-IgG antibodies
A
Rheumatoid arthritis (systemic inflammation, joint pannus, boutonnière deformity)
6
Q
Antimitochondrial antibodies (AMAs)
A
1° biliary cirrhosis (female, cholestasis, portal hypertension)
7
Q
Antineutrophil cytoplasmic antibodies (ANCAs)
A
Microscopic polyangiitis and Churg-Strauss syndrome (MPO-ANCA/p-ANCA);
granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA)
8
Q
Antinuclear antibodies (ANAs: anti-Smith and anti-dsDNA)
A
SLE (type III hypersensitivity)
9
Q
Antiplatelet antibodies
A
Idiopathic thrombocytopenic purpura
10
Q
Anti-topoisomerase antibodies
A
Diffuse systemic scleroderma
11
Q
Anti-transglutaminase/anti-gliadin/anti-endomysial
antibodies
A
Celiac disease (diarrhea, distention, weight loss)
12
Q
“Apple core” lesion on abdominal x-ray
A
Colorectal cancer (usually left-sided)
13
Q
Azurophilic peroxidase + granular inclusions in granulocytes
and myeloblasts
A
Auer rods (AML, especially the promyelocytic [M3] type)
14
Q
Bacitracin response
A
Sensitive: Streptococcus pyogenes (group A); resistant: Streptococcus agalactiae (group B)
15
Q
“Bamboo spine” on x-ray
A
Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)
16
Q
Basophilic nuclear remnants in RBCs
A
Howell-Jolly bodies (due to splenectomy or nonfunctional spleen)
17
Q
Basophilic stippling of RBCs
A
Lead poisoning or sideroblastic anemia
18
Q
Bloody tap on LP
A
Subarachnoid hemorrhage
19
Q
“Boot-shaped” heart on x-ray
A
Tetralogy of Fallot, RVH
20
Q
Branching gram-positive rods with sulfur granules
A
Actinomyces israelii
21
Q
Bronchogenic apical lung tumor on imaging
A
Pancoast tumor (can compress sympathetic ganglion and cause Horner syndrome)
22
Q
“Brown” tumor of bone
A
Hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)
23
Q
Cardiomegaly with apical atrophy
A
Chagas disease (Trypanosoma cruzi)
24
Q
Cellular crescents in Bowman capsule
A
Rapidly progressive crescentic glomerulonephritis
25
“Chocolate cyst” of ovary
Endometriosis (frequently involves both ovaries)
26
Circular grouping of dark tumor cells surrounding pale
| neurofibrils
Homer-Wright rosettes (neuroblastoma, medulloblastoma, retinoblastoma)
27
Colonies of mucoid Pseudomonas in lungs
Cystic fibrosis (autosomal recessive mutation in CFTR gene --> fat-soluble vitamin deficiency and mucous plugs)
28
decreased AFP in amniotic fluid/maternal serum
Down syndrome or other chromosomal abnormality
29
Degeneration of dorsal column nerves
Tabes dorsalis (3° syphilis), subacute combined degeneration (dorsal columns and lateral corticospinal tracts affected)
30
Depigmentation of neurons in substantia nigra
Parkinson disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)
31
Desquamated epithelium casts in sputum
Curschmann spirals (bronchial asthma; can result in whorled mucous plugs)
32
Disarrayed granulosa cells in eosinophilic fluid
Call-Exner bodies (granulosa-theca cell tumor of the ovary)
33
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
Koilocytes (HPV: predisposes to cervical cancer)
34
Enlarged cells with intranuclear inclusion bodies
“Owl eye” appearance of CMV
35
Enlarged thyroid cells with ground-glass nuclei
“Orphan Annie” eyes nuclei (papillary carcinoma of the thyroid)
36
Eosinophilic cytoplasmic inclusion in liver cell
Mallory body (alcoholic liver disease)
37
Eosinophilic cytoplasmic inclusion in nerve cell
Lewy body (Parkinson disease)
38
Eosinophilic globule in liver
Councilman body (toxic or viral hepatitis, often yellow fever)
39
Eosinophilic inclusion bodies in cytoplasm of hippocampal
| and cerebellar nerve cells
Negri bodies of rabies
40
Extracellular amyloid deposition in gray matter of brain
Senile plaques (Alzheimer disease)
41
Giant B cells with bilobed nuclei with prominent inclusions
| “owl’s eye”
Reed-Sternberg cells (Hodgkin lymphoma)
42
Glomerulus-like structure surrounding vessel in germ cells
Schiller-Duval bodies (yolk sac tumor)
43
“Hair on end” (crew-cut) appearance on x-ray
β-thalassemia, sickle cell anemia (marrow expansion)
44
hCG elevated
Choriocarcinoma, hydatidiform mole (occurs with and without embryo, and multiple pregnancy)
45
Heart nodules (granulomatous)
Aschoff bodies (rheumatic fever)
46
Heterophile antibodies
Infectious mononucleosis (EBV)
47
Hexagonal, double-pointed, needle-like crystals in bronchial secretions
Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)
48
High level of D-dimers
DVT, PE, DIC
49
Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Ghon complex (1° TB: Mycobacterium bacilli)
50
“Honeycomb lung” on x-ray or CT
Interstitial pulmonary fibrosis
51
Hypercoagulability (leading to migrating DVTs and vasculitis)
Trousseau syndrome (adenocarcinoma of pancreas or lung)
52
Hypersegmented neutrophils
Megaloblastic anemia (B12 deficiency: neurologic symptoms; folate deficiency: no neurologic symptoms)
53
Hypertension, hypokalemia, metabolic alkalosis
Conn syndrome
54
Hypochromic, microcytic anemia
Iron deficiency anemia, lead poisoning, thalassemia (fetal hemoglobin sometimes present)
55
Increased AFP in amniotic fluid/maternal serum
Dating error, anencephaly, spina bifida (neural tube defects)
56
Increased uric acid levels
Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics
57
Intranuclear eosinophilic droplet-like bodies
Cowdry type A bodies (HSV or CMV)
58
Iron-containing nodules in alveolar septum
Ferruginous bodies (asbestosis: increased chance of mesothelioma)
59
Keratin pearls on a skin biopsy
Squamous cell carcinoma
60
Large lysosomal vesicles in phagocytes, immunodeficiency
Chédiak-Higashi disease (congenital failure of phagolysosome formation)
61
“Lead pipe” appearance of colon on barium enema x-ray
Ulcerative colitis (loss of haustra)
62
Linear appearance of IgG deposition on glomerular basement membrane
Goodpasture syndrome
63
Low serum ceruloplasmin
Wilson disease (hepatolenticular degeneration)
64
“Lumpy bumpy” appearance of glomeruli on immunofluorescence
Poststreptococcal glomerulonephritis (immune complex deposition of IgG and C3b)
65
Lytic (“hole punched”) bone lesions on x-ray
Multiple myeloma
66
Mammary gland (“blue domed”) cyst
Fibrocystic change of the breast
67
Monoclonal antibody spike
```
Multiple myeloma (usually IgG or IgA);
Monoclonal gammopathy of undetermined significance (MGUS consequence of aging);
Waldenström (M protein = IgM) macroglobulinemia;
Primary amyloidosis
```
68
Mucin-filled cell with peripheral nucleus
“Signet ring” (gastric carcinoma)
69
Narrowing of bowel lumen on barium x-ray
“String sign” (Crohn disease)
70
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
Granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA) and Goodpasture syndrome (anti–basement membrane antibodies)
71
Needle-shaped, negatively birefringent crystals
Gout (monosodium urate crystals)
72
Nodular hyaline deposits in glomeruli
Kimmelstiel-Wilson nodules (diabetic nephropathy)
73
Novobiocin response
Sensitive: Staphylococcus epidermidis; resistant: Staphylococcus saprophyticus
74
“Nutmeg” appearance of liver
Chronic passive congestion of liver due to right heart failure
75
“Onion skin” periosteal reaction
Ewing sarcoma (malignant round-cell tumor)
76
Optochin response
Sensitive: Streptococcus pneumoniae; resistant: viridans streptococci
77
Periosteum raised from bone, creating triangular area
Codman triangle on x-ray (osteosarcoma, Ewing sarcoma, pyogenic osteomyelitis)
78
Podocyte fusion or “effacement” on electron microscopy
Minimal change disease (child with nephrotic syndrome)
79
Polished, “ivory-like” appearance of bone at cartilage erosion
Eburnation (osteoarthritis resulting in bony sclerosis)
80
Protein aggregates in neurons from hyperphosphorylation of tau protein
Neurofibrillary tangles (Alzheimer disease) and Pick bodies (Pick disease)
81
Psammoma bodies
Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary
82
Pseudopalisading tumor cells on brain biopsy
Glioblastoma multiforme
83
RBC casts in urine
Acute glomerulonephritis
84
Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells
Reinke crystals (Leydig cell tumor)
85
Renal epithelial casts in urine
Acute toxic/viral renal injury
86
Rhomboid crystals, positively birefringent
Pseudogout (calcium pyrophosphate dihydrate crystals)
87
Rib notching
Coarctation of the aorta
88
Ring-enhancing brain lesion in AIDS
Toxoplasma gondii, CNS lymphoma
89
Sheets of medium-sized lymphoid cells with scattered pale, tingible body–laden macrophages (“starry sky” histology)
Burkitt lymphoma (t[8:14] c-myc activation, associated with EBV; “black sky” made up of malignant cells)
90
Silver-staining spherical aggregation of tau proteins in neurons
Pick bodies (Pick disease: progressive dementia, changes in personality)
91
“Soap bubble” in femur or tibia on x-ray
Giant cell tumor of bone (generally benign)
92
“Spikes” on basement membrane, “dome-like” subepithelial deposits
Membranous glomerulonephritis (may progress to nephrotic syndrome)
93
Stacks of RBCs
Rouleaux formation (high ESR, multiple myeloma)
94
Stippled vaginal epithelial cells
“Clue cells” (Gardnerella vaginalis)
95
“Tennis racket”-shaped cytoplasmic organelles (EM) in Langerhans cells
Birbeck granules (Langerhans cell histiocytosis or histiocytosis X: eosinophilic granuloma)
96
Thrombi made of white/red layers
Lines of Zahn (arterial thrombus, layers of platelets/RBCs)
97
“Thumb sign” on lateral x-ray
Epiglottitis (Haemophilus influenzae)
98
Thyroid-like appearance of kidney
Chronic bacterial pyelonephritis
99
“Tram-track” appearance of capillary loops of glomerular basement membranes on light microscopy
Membranoproliferative glomerulonephritis
100
Triglyceride accumulation in liver cell vacuoles
Fatty liver disease (alcoholic or metabolic syndrome)
101
“Waxy” casts with very low urine flow
Chronic end-stage renal disease
102
WBC casts in urine
Acute pyelonephritis
103
WBCs that look “smudged”
CLL (almost always B cell)
104
“Wire loop” glomerular capillary appearance on light microscopy
Lupus nephropathy
105
Yellowish CSF
Xanthochromia (e.g., due to subarachnoid hemorrhage)
